| 1. |
- Bergqvist, D, et al.
(författare)
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The cost-effectiveness of prevention of post-operative thromboembolism
- 1990
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Ingår i: Acta chirurgica Scandinavica. Supplementum. - 0301-1860. ; 556, s. 36-41
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Tidskriftsartikel (refereegranskat)abstract
- In recent years, value for money in health care has become of increasing concern. There are various ways to perform an economic evaluation, the most simple being a cost-effectiveness analysis, where differences in costs will influence the choice between methods. Cost-utility and cost-benefit analyses represent more advanced forms of economic evaluations. In this cost-effectiveness analysis, the following three strategies aimed at solving the problem of post-operative thromboembolic complications were compared: (a) no prophylaxis but treatment of occurring complications, (b) general prophylaxis with low-dose heparin for patients over 40 years of age and (c) selective treatment based on post-operative surveillance with a fibrinogen uptake test. Moreover, these alternatives were evaluated for three types of surgery: general abdominal surgery, cholecystectomy and elective hip surgery. Costs for thromboembolic and haemorrhagic complications were estimated from data available for patients hospitalized in Malmo. A sensitivity analysis was made with regard to the frequency of thrombosis, prophylactic effect and treatment costs. Health care costs would be minimized with general prophylaxis in hip and general surgery, whereas no prophylaxis is the most cost-effective alternative in cholecystectomy patients, i.e. with a frequency of thrombosis below 8%. General prophylaxis minimized the duration of patients' health losses due to thromboembolic disease in general, as well as in elective hip surgery. After cholecystectomy, no difference in health loss for the individual was found between the alternative of no prophylaxis and general prophylaxis. Selective treatment was always the least satisfactory alternative in all categories and always the most expensive.
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| 2. |
- Mätzsch, Thomas, et al.
(författare)
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Safety and efficacy of a low molecular weight heparin (Logiparin) versus dextran as prophylaxis against thrombosis after total hip replacement
- 1988
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Ingår i: Acta chirurgica Scandinavica. Supplementum. - 0301-1860. ; 543, s. 80-84
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Tidskriftsartikel (refereegranskat)abstract
- In order to study the plasma levels of factor XaI and IIaI activity an enzymatically depolymerized low molecular weight heparin (LMW-heparin; Logiparin) was given s.c. in a dose of 35 XaI mu/kg b.w. once daily for 7 days to 10 patients undergoing total hip replacement (THR) in a pilot study. The XaI activity was less than or equal to 0.24 XaI units/ml and the IIaI activity less than or equal to 0.043 IIaI mu/ml. No accumulation of the activities were seen. No phlebographically verified thrombi or any bleeding complications were registered. From this study it was concluded that the given dose of Logiparin was safe with regard to bleeding complications. Based on these data, an open, randomized controlled trial was started. In this main study the thromboprophylactic effect of the LMW-heparin (Logiparin) in a dose of 35 XaI mu/kg b.w. once daily was compared with that of dextran 70 in patients undergoing THR. 100 patients were randomized. The over-all thrombosis rate was 28% in patients treated with LMW-heparin and 39% in those given dextran, a non-significant difference. No bleeding complications, deaths or pulmonary embolism were recorded in either group. Peroperative blood loss and transfusion requirements were similar in the two groups. In conclusion, the investigated LMW-heparin (Logiparin) is safe and effective in preventing postoperative thromboembolism in patients undergoing total hip replacement, but the dosage can probably be optimized.
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| 3. |
- Rösel, D, et al.
(författare)
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LA-ICP-MS U–Pb dating of detrital rutile and zircon from the Reynolds Range: A window into the Palaeoproterozoic tectonosedimentary evolution of the North Australian Craton
- 2014
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Ingår i: Precambrian Research. - : Elsevier BV. - 0301-9268 .- 1872-7433. ; 255:1, s. 381-400
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Tidskriftsartikel (refereegranskat)abstract
- The Palaeoproterozoic Reynolds Range of the Arunta Region, central Australia, comprises a series of shallow marine clastic sediments (Reynolds Range Group) which overlies deeper water sequences of turbidites (Lander Rock Formation) and minor sandstones (“unnamed sandstone”). U–Pb age data collected from detrital rutile and zircon in these rocks indicates these sequences contain very similar age spectra, although with a notable and important shift to younger ages within the stratigraphically younger Reynolds Range Group. Detrital zircons from the “unnamed sandstone” directly underlying the unconformity with the Reynolds Range Group contain a major age component at ca. 1860 Ma, together with a wide spread of ages between ca. 3.2 and 2.0 Ga and a minor age component of 1830–1805 Ma. Detrital rutile from the same rock yield a unimodal age spectrum with a mean age of ca. 1840 Ma. The detrital zircon age spectrum from the Reynolds Range Group is similar, although the youngest cluster of ages is younger and dates to between 1800 Ma and 1780 Ma. Detrital rutile from these rocks yield a unimodal age spectrum with a mean age of ca. 1790 Ma. Although the observed differences in ages are subtle, we suggest these nevertheless mark a significant change in provenance. We attribute the predominance of 1860–1820 Ma detrital zircon and 1840 Ma detrital rutile within the “unnamed sandstone” and the characteristic ca. 1860 Ma detrital zircon age cluster in previously published provenance studies from the Lander Rock Formation to uplift and erosion of the Halls Creek–Pine Creek Orogen. This orogenic belt marks collision between the North Australian and Kimberley cratons, an event dated to between 1835 Ma and 1810 Ma and which incorporates marginally older rocks dating to 1860 Ma from the foreland of the Kimberley Craton. By contrast we attribute the influx of younger rutile and zircon, together with a distinct facies change observed with the onset of the deposition of the Reynolds Range Group, to a shift in provenance region to the Yapungku Orogen, which marks the collision between the West Australian and North Australian cratons and is dated to ca. 1800–1765 Ma. A change in provenance is additionally consistent with significant differences in rutile trace element composition. The Lander Rock Formation and the Reynolds Range Group are stratigraphically correlated with sedimentary rocks that overly large parts of the North Australian Craton. We suggest this indicates spatially continuous basinal conditions within the North Australian Craton between ca. 1840 Ma and 1780 Ma, although the erosion and drainage systems feeding this basin were strongly influenced by the collision and orogenesis along the northwest and southwest margins of the North Australian Craton.
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